Provider Demographics
NPI:1821017674
Name:CLARINGBOLD, THOMAS (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:CLARINGBOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1509 N MCEWAN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:CLARE
Mailing Address - State:MI
Mailing Address - Zip Code:48617-1113
Mailing Address - Country:US
Mailing Address - Phone:989-802-8811
Mailing Address - Fax:989-802-8809
Practice Address - Street 1:1509 N MCEWAN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:CLARE
Practice Address - State:MI
Practice Address - Zip Code:48617-1113
Practice Address - Country:US
Practice Address - Phone:989-802-8811
Practice Address - Fax:989-802-8809
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MITC011841207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG52794Medicare UPIN